3/9/15 Oz 78 A.M. Preshot Wondering what to do - Special condition

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Ian & Oz

Ian & Oz

Member Since 2014
Hello,
It's been awhile since I've been on here, due to Oz staying at a certain level for awhile. We suspected his insulin was losing power & it turns out it was fizzling out sooner than we thought. He started on his new insulin bottle, the second of March. This morning his preshot number is 78, a new low preshot number. I know from talking to some of you before that when you shoot a low number it should just flatten out instead of a super drop, but it's been awhile since we've been in this territory. I'm stalling at the moment, I tested him at 9:28 central time A.M., wondering if I should give him his shot or stall or skip, based on how quickly he's gotten to this preshot number.

Ian
 
It looks like on 2/17 you shot a 68 and Oz went up a bit after that -- probably a bounce.

Personally, in my opinion, if you are going to be around to test and have the tools to bring him up if he decides to drop lower, I would go ahead and shoot and see if you can keep him in these nice healing numbers.

I think @Marje and Gracie is online -- maybe she'll be able to chime in as well.
 
Thank you Suzanne.
You're right, I forgot about the 68. I've been used to his levels on the fading insulin. When he had the 68 preshot number, he was still on the old insulin, so the new stuff may have a different reaction.?
 
I've been testing him since then & within the last 15 minutes he's begun to drop, he's now at 66. I don't think I'm supposed to shoot a dropping number. He hasn't had any food yet.
 
Hi. It's still within meter variance. How much longer can you stall? The problem is if you stall too long and don't feed he could drop more.
 
Sorry for the delay in my response. My internet crapped out at work. :banghead:

The drop from 78 to 66 would actually put me on the wary end of things.

If you wanted to make sure Oz got some insulin, you could give a half dose. A BCS (big chicken shot). It's low enough that it probably wouldn't affect his BGs too much, but may keep him from going too far up, like you might see with a skipped shot.

Ultimately, you are the one that holds the syringe. If you aren't comfortable shooting, call it a day, relax and get back on schedule tonight. One skipped shot won't derail him too much.
 
From the "Myths debunked" thread:

Re: Tight Regulation Protocols: Myths Debunked

Here’s another misconception I have seen floating around LL from time to time:

“Don’t Shoot a Dropping Number”

I LOVE when I have an opportunity to shoot a dropping number! It’s a great way to take advantage of the overlap provided by Lantus and Levemir. Low or dropping preshots are a GIFT that helps us move our cats closer to tight regulation. This is a Tight Regulation forum, so grab it!

Remember, you are not shooting the number your cat is at now. You are shooting the number he will be at hours from now, when the insulin kicks in. You have probably noticed that once your cat starts to rise, he/she can rise very quickly. If you shoot, you will also be feeding, which can also contribute to the rise. If you wait for the rise to start before shooting, you might be behind before you even get started. When you have an opportunity to get the insulin in before the rise starts, rejoice and SHOOOOOOT!!! Feed as usual and monitor the beginning of the cycle. Feed strategically in the first couple of hours if you need to prop him up until the rise begins. He will still rise, but probably not as fast or as far because the insulin will be there beforehe needs it.

We do have guidelines for “Shooting Low Numbers,” but those guidelines are primarily an educational tool to help caregivers learn to shoot low. Once you know your cat’s response to food and insulin, then usually you will have the best results from shooting at +12, whether the number is high, low, rising, falling, whatever. Of course, common sense applies. 30s are not shootable, and 40s are not shootable unless you have TONS of data to show that it is ok for your cat (if you are wondering if that is you, it is not. ;-) Almost nobody should be shooting 40s and if you are in that category then you already know it). You do not want to shoot if there is any reason to believe you will not be able to keep your cat safe.

These insulins are not at their best when we ask them to pull down high numbers. They are GREAT at grabbing onto lower numbers and holding them flat. SHOOOOOOOOT!!!
Click to expand...

That being said, you have a couple of choices....shoot the scheduled dose, go ahead and feed and just make sure to get a +1 and +2 (or even sooner if you're concerned) and feed as necessary to keep him safe.

Shoot a BCS (one time lower dose) to keep some insulin in so you don't drain the depot as much (but you'd still want to keep an eye on the numbers)

Skip this shot and let the depot drain today and resume normal shot tonight.

I can't stay online to help you, so it has to be your final decision.....remember the sticky on Shooting and Handling low numbers is available if you need it, as well as using the 911 on your subject line.

Good luck with whatever you choose!
 
Thank you Suzanne & Tiff.
I decided to skip & just fed him. The big question now is, What To Do Next Time. I'll look at that Tiff. The only info I have is what I've learned so far & I was told not to shoot a dropping number so I skipped based on that.
 
If you do shoot, I will be around. Work internet just came back up and I have FDMB pulled up on my phone and refreshing it every few minutes.
 
Ian & Oz said:
Thank you Suzanne & Tiff.
I decided to skip & just fed him. The big question now is, What To Do Next Time. I'll look at that Tiff. The only info I have is what I've learned so far & I was told not to shoot a dropping number so I skipped based on that.
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Looks like we cross posted.

Safety first. I don't think skipping was a bad idea. Let's see how Oz responds to the skipped shot and the next few cycles and deal with next time when it happens. :)

One thing about shooting a dropping number is to know how your cat will respond, and be prepared to intervene if necessary. While I think shooting a low, dropping number can be advantageous in some cases, I do think YOU need to be confident in doing it.
 
Thank you Suzanne & Chris. I've skipped his shot based on my previous response & the fact that he's on the new insulin, which is really starting to take effect. This morning would be the 12th or 13th cycle since he began the new insulin. So should he be caught up on the effects of a stronger batch? I read the "Debunking the Myth" info & still wonder if the new insulin won't have an additional impact on dropping numbers.
 
Ian & Oz said:
Thank you Suzanne & Chris. I've skipped his shot based on my previous response & the fact that he's on the new insulin, which is really starting to take effect. This morning would be the 12th or 13th cycle since he began the new insulin. So should he be caught up on the effects of a stronger batch? I read the "Debunking the Myth" info & still wonder if the new insulin won't have an additional impact on dropping numbers.
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If the insulin was actually fizzling out, then yes, it could have an impact on dropping numbers. I think skipping was the wise, safe decision. I think he's probably had enough time to get used to it, but again...YOU have to be confident in what you are shooting. See how he does at tonight's PMPS. And shoot your regular dose and monitor his response. If he drops too low, then you know the insulin is doing its thing and you can reduce. For now...enjoy your free day without having to monitor! :)
 
Sorry I didn't see your post before I got off to take care of Gracie.

Ian...on the SS, could you remove the actual times on the PS and put the + numbers such as +11.5, +12, etc becausd the times don't tell me anything.

If 78 was his PS, you should have shot it since you would be home. The longer you stall, the more he will drop. So you want to shoot thst very safe number on time, full dose, feed, get a +1. You are experienced enough and it's time you let Oz have the benefit of you shooting green numbers. The fact that you changed the insulin on 3/3 is not an issue now.

I don't know where you are now in the cycle and if you've already fed? If so, how long ago and what is his BG now?
 
Hi Marje, thanks for answering. I'm still not quite sure how to translate the actual time into "+" numbers. I put the actual times that the readings were taken, 9:28 - 9:58 - 10:19 & 10:23, what would be the "+" version of this? In the past I was told that the longer you wait he will continue to rise, which is what he's done before, also not to shoot a falling number. This "Debunking the Myth" info is new to me. He's been fed & I skipped his shot based on my previous knowledge.
 
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As an example, if his normal shot time is 9:30, that's +12. So if you test at 9:28 and don't shoot, You record it as +12. 9:58 would be +12.5; 10:19 would be +12.75, and 10:23 ...well that's basically the same. When stalling, you don't need to test more than every 20 mins.

Sometimes they rise when you stall because they are at the end of a cycle but sometimes they don't and you want to take advantage of carryover and overlap. I would not necessarily have a brand new member do this but you've got slot of data and you test...you've been here a while and you've handled low numbers.

How long ago since he fed and what is his BG now? If you fed a small amount of LC and it's been at least 30 mins and you can afford to get back on schedule slowly, you could still shoot.

Remember that, in general (and this advice does not apply to new members who need to learn to shoot lower numbers gradually), that when the BG is above 50 and you will be there to monitor and have supplies, stalling, skipping, and/or shooting a reduced dose are for the CG....not the cat. :) Yes...sometimes there are extenuating circumstances like you have to leave, you are sick or don't feel well, you don't have supplies, or you just need a mental/physical health break.
 
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